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主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

单纯前路手术及椎体前内固定治疗颈椎骨折脱位 伴多节段颈髓损伤的临床疗效

郭跃进

陕西省延安市志丹县医院,陕西 延安,717500

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摘要:

目的 探究单纯前路手术及椎体前内固定治疗颈椎骨折脱位伴多节段颈髓损伤的临床疗效。方法 选择我院颈椎骨折脱位伴多节段颈髓损伤的患者 78例,随机分为试验组与对照组,各 39例。试验组患者行单纯前路椎间盘及部分切除、牵开复位、椎间植骨融合钛板椎体前内固定,对照组患者行颅骨牵引复位、颈后路侧块螺钉内固定术。观察两组患者脊髓的损伤程度(ASIA)及颈椎 JOA 评分。结果 术后,试验组患者的 ASIA 分级 D、E 级占比均略高于对照组(P>0.05);治疗后,两组患者的 JOA 评分明显优于治疗前,且试验组优于对照组(P<0.05)。结论 单纯前路手术及椎体前内固定治疗颈椎骨折脱位伴多节段颈髓损伤效果确切,有助于术后恢复。

关键词:前路手术;椎体前内固定;颈椎骨折

中图分类号: R687.3文献标志码:A文章编号:2096-1413(2018)07-0066-02

    Clinical effect of simple anterior approach and anterio rinternal fixation
    in the treatment of cervical spine fracture dislocation complicated
    with multiple cervicals pinalcord injury


    GUO Yue-jin
    (the Hospital of Zhidan County in Yan`an, Yan`an 717500, China)


    ABSTRACT:  Objective To investigate the clinical effects of simple anterior approach and anterior internal fixation in the treatment of cervical spine fracture dislocation complicated with multiple cervical spinal cord injury. Methods Seventy-eight patients with cervical spine fracture dislocation complicated with multiple cervical spinal cord injury in our hospital were selected and randomly divided into experimental group and control group, with 39 cases in each group. The experiment algroup was treated with simple anterior discectomy and partial resection,distraction reduction,interbody fusion and peptideplateanterior fixation.The control group received traction reduction of skull and posterior cervical lateral mass screw fixation.The degree of spinalcord injury (ASIA) and cervical spine JOA scores were observed in the two groups. Results The proportions of grade D and E of post operative ASIS grade in the experimental group were slightly higher than those in the control group (P>0.05). After treatment, the JOA scores of the two groups were than before treatment, and those of the experimental group was better than the control group (P<0.05). Conclusion The simple anterior approach and anterior in ternal fixation in the treatment of cervical spine fracture dislocation complicated with multiple cervical spinal cord injuries has accurate effect, and it is helpful for there covery of neuro logical function after operation.                                          

    KEYWORDS:anterior approach surgery; anterior internal fixation; cervical fracture

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